Journal
TROPICAL MEDICINE AND INFECTIOUS DISEASE
Volume 7, Issue 10, Pages -Publisher
MDPI
DOI: 10.3390/tropicalmed7100258
Keywords
Leishmania; Leishmaniasis; kidney transplant; allograft; infection; treatment; tropical disease; complications; outcomes
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Current knowledge on Leishmania infection after kidney transplantation is limited. We performed a systematic review and selected 70 studies with a total of 159 cases of Leishmaniasis in kidney transplant recipients. Most patients were adult, male, and Caucasian. The main treatment options included pentavalent antimonial and liposomal amphotericin B, but the results were mixed. Overall, the outcomes were concerning, with several patients dying or losing their transplant.
Current knowledge on Leishmania infection after kidney transplantation (KT) is limited. In order to offer a comprehensive guide for the management of post-transplant Leishmaniasis, we performed a systematic review following the latest PRISMA Checklist and using PubMed, Scopus, and Embase as databases. No time restrictions were applied, including all English-edited articles on Leishmaniasis in KT recipients. Selected items were assessed for methodological quality using a modified Newcastle-Ottawa Scale. Given the nature and quality of the studies (case reports and retrospective uncontrolled case series), data could not be meta-analyzed. A descriptive summary was therefore provided. Eventually, we selected 70 studies, describing a total of 159 cases of Leishmaniasis. Most of the patients were adult, male, and Caucasian. Furthermore, they were frequently living or travelling to endemic regions. The onset of the disease was variable, but more often in the late transplant course. The clinical features were basically similar to those reported in the general population. However, a generalized delay in diagnosis and treatment could be detected. Bone marrow aspiration was the preferred diagnostic modality. The main treatment options included pentavalent antimonial and liposomal amphotericin B, both showing mixed results. Overall, the outcomes appeared as concerning, with several patients dying or losing their transplant.
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